黑斑息肉综合征52例内镜与外科治疗

The endoscopic and surgical treatment of 52 patients with Peutz-Jegher Syndrome

目的探讨黑斑息肉综合征(PJS)的内镜与外科手术治疗方案及随访计划.方法 回顾分析我院1980～2003年间收治的52例PJS患者的临床资料.结果小肠息肉的发生率最高,达95%,其次为大肠息肉和胃息肉.大部分息肉为错构瘤性,部分为腺瘤性,恶性肿瘤发生率为13.5%(7/52).大部分息肉行内镜下切除,不能内镜下切除的息肉行外科手术治疗,部分患者进行术中内镜配合治疗.术后内镜复查,随访时间越长,息肉的再检出率越高(P＜0.05).结论 PJS患者胃肠道息肉首选内镜下治疗,其次选择剖腹探查手术治疗和配合手术中的内镜治疗.患者应定期行内镜复查,终生进行随访治疗.

Objective To rationalize the endoscopic and surgical treatment of patients with Peutz-Jegher syndrome (PJS).Methods Clinical data were retrospectively analyzed in 52 patients admitted toNanfang Hospital from1980 to2003.Results The incidence of the polyps in the small intestine was high-er than that in the stomach and colon.The incidence of canceration was 13.5%.Most gastric and colorectalpolyps were resected by endoscopic treatment.Polyps that cannot be treated by endoscopy were managed byoperation,accompanied by intraoperative endoscopic treatment.The longer the follow-up time was, thehigher recurrence rate of polyps was.Conclusions Endoscopic treatment is the main way for PJS polyps;laparotomy should be considered when the polyps couldn’t be treated by endoscopy,or in the acute situa-tion.Intraoperative endoscopy is effective to treat PJS polyps.Follow-up by endoscopy should be performedfor lifetime.